Insurance Carrier to Cover Naturopathic Care
As a naturopathic patient, you may have been disappointed to learn that health insurance does not cover naturopathic care in the state of California. Or maybe the lack of insurance coverage prevented you from establishing care with a naturopathic doctor in the first place.
Well, all that is about to change with the announcement that Blue Shield is now reimbursing patients for a number of services performed by naturopathic doctors.
The covered services include venipuncture (blood draws), IV infusions, vitamin B-12 injections, and trigger point therapy. Reimbursable lab work includes the complete blood count (CBC), comprehensive metabolic panel (CMP), vitamin D, thyroid hormones, and allergy testing.
Note that this list does not currently include reimbursement for office visits or supplements, and the above items may be noted as exclusions in your individual health plan. You should still expect to pay for naturopathic care out-of-pocket, and will need to submit a superbill for these charges to your insurer following the procedures.
The Affordable Care Act (also known as ObamaCare) was written with a provision stating that health insurers cannot discriminate against naturopathic doctors and other licensed health care providers. Now that Blue Shield has taken steps to comply with the law, other insurers should follow suit.
In the meantime, patients with other health plans can file a complaint in writing if their claims for payment of naturopathic services are denied. They should also contact the Health Consumer Alliance at (888) 804.3536 for assistance. The Alliance advocates for consumers and will assist in getting the denial reviewed by the California Department of Managed Health Care or the Department of Insurance. The California Naturopathic Doctors Association has a template to use when appealing a denial, available at www.calnd.org/filing-a-complaint.
This news follows the 2016 announcement that the Hawaii health insurance provider Hawaii Medical Service Association (HMSA) now allows their insured members to choose a naturopathic doctor as their primary care physician, a big step forward for the industry.
Naturopathic doctors increase the variety of provider options available to consumers, improve access to chronic disease prevention and treatment, and refocus health care on wellness. Using naturopathic medical care can reduce costs to both the individual and insurers.
Please use the benefits to which you are entitled and help expand insurance coverage for all by filing a complaint if your claim is denied.
Editors Note (2.7.19): I recently looked into this and was told by Blue Shield, my insurer, that they would only cover IV therapy if administered by an MD within their network (of which their are none in the Coachella Valley). Based on additional research from the California naturopathic state board, the NMC, I plan to file a complaint and will update this article accordingly.
Dr. Jessica Needle is a naturopathic doctor practicing at Optimal Health Center in Palm Desert and can be reached at (760) 568.2598.